Obesity and metabolic alterations: impacts on mobility, functional capacity, and quality of life

Abstract

Introduction: Obesity is a condition of great clinical significance, especially during aging, as it is associated not only with excess adiposity but also with metabolic alterations that can impact physical and functional health. The presence of abdominal obesity, metabolic syndrome, and glycemic abnormalities may be linked to impaired mobility, reduced functional capacity, and poorer quality of life, necessitating an approach that considers body composition and the preservation of functional independence alongside body weight. Objective: To analyze the impact of obesity and metabolic alterations on mobility, functional capacity, and quality of life, with an emphasis on the elderly population, and to identify the effects of interventions involving weight loss, physical exercise, and lifestyle changes on these outcomes. Methods: This is an integrative literature review of a qualitative and descriptive nature. Searches were conducted in the PubMed/MEDLINE, SciELO, and Virtual Health Library (VHL) databases using descriptors and terms related to obesity, metabolic syndrome, metabolic alterations, mobility, functional capacity, physical function, and quality of life, combined using the Boolean operators AND and OR. Studies addressing the relationship between obesity or metabolic alterations and the functional outcomes under investigation, as well as interventions aimed at weight loss and the improvement of physical function, were included. Initially, 68 records were identified; 23 duplicates were removed, leaving 45 for screening. After evaluating titles and abstracts, 25 records were excluded, and 20 articles were assessed in full text. Ultimately, 7 studies met the established criteria and constituted the final sample. Results: The studies demonstrated an association between obesity—particularly abdominal obesity—and metabolic alterations with greater impairment of physical function and mobility. Metabolic syndrome and hyperglycemia were also linked to an increased risk of mobility decline, while the presence of metabolic abnormalities was associated with poorer quality of life, particularly regarding aspects related to physical health and well-being. Regarding interventions, combining diet and exercise yielded benefits for weight loss, physical performance, and quality of life, whereas resistance training demonstrated superior preservation of lean mass during weight loss. Multicomponent interventions involving nutrition, exercise, and behavioral changes also showed improvements in physical function and potential reductions in body mass and body fat, although the certainty of the evidence varied across the outcomes assessed. Conclusion: Obesity and metabolic abnormalities are linked to impaired mobility, functional capacity, and quality of life, particularly in the elderly population. Strategies combining nutritional intervention, physical exercise, and behavioral changes have the potential to promote metabolic and functional benefits, with due consideration given to preserving lean mass and musculoskeletal health during the weight loss process. Thus, obesity management should be multidimensional and individualized, addressing not only weight reduction but also the maintenance of functionality, independence, and quality of life.